Sutures are stitches used to close open wounds and/or surgical incisions of a patient. A medical practitioner generally uses a needle with an attached thread to substantially sew two adjacent sections of skin together to close the wound or incision. Surgical knots are often used to secure the sutures and ensure proper healing.
Effective surgical knots may be difficult to tie, thereby potentially allowing reopening of the wound or incision. In such cases, the patient may be at risk of infection if the wound or incision reopens. In another example, sutures and surgical knots contacting the skin can be inflammatory and/or become “ingrown” and actually impede healing of the wound or incision. Additionally, complications may arise if the suture is tied too tightly or too loosely.
For example, wound eversion may be a desired outcome of suture technique, especially in high-tension areas of the skin, such where skin overlies the shoulder, knee, angle of the mandible, etc. Wound eversion occurs when the two wound surfaces are horizontally opposed into one another such that the closed incision is under no tension and topographically lies in a plane above the resting horizontal skin plane. Wound closures with maximal eversion resist excessive widening of the scar due to ongoing ambient stresses in the high-tension area during the wound healing and scar maturation processes. However, wound eversion can be technically difficult to achieve for less skilled operator, and a device to facilitate this is desirable. Further, there may be excessive tension on closures where an excisional defect is present in the skin. When suture is placed under excessive tension to close such wounds, the suture itself can slice through the skin (“cheesewiring”). In this setting, a surgical device interposed between the skin and suture for the purpose of spreading the suture's force over a broader area is desirable. The embodiments in the following descriptions integrate these two important functions into a single device, that is the achievement of maximal wound eversion closure with prevention of suture-induced trauma to the skin. Thus, there exists a need for suture devices that improve upon and advance the design of known suture devices.